Once you turn 50, you enter a critical time in your life where just a few decisions about your health will have a huge impact on how successfully you age over the next several, and hopefully many more, decades. In this article, I want to discuss the critical mistakes I see people making over and over again, mistakes that can unfortunately lead to issues like heart attacks, strokes, dementia, and even many cancers.
I used to take care of acutely ill patients in the hospital, where many people came in very sick with completely preventable conditions. Still, unfortunately, it was too late to reverse by that point. So if you're in your 50s or even your 40s, now is the time to correct these mistakes before it's too late.
I'll go over nutrients and supplements that are often promoted as healthy but that you should actually be cautious with, evidence-based supplements most people should consider incorporating, important steps for reversing chronic disease and slowing aging, and at the end, an important blood test that's vital for heart disease prevention but that most doctors don't check, or even know about.
Hi, I am Dr. Leonid Kim. I am board-certified in Obesity and Internal Medicine, and I provide the most up-to-date, evidence-based information on weight loss, metabolic health, and longevity. Let's get into it.
Supplements to Be Cautious With
Vitamin D (in High Doses)
First up, be careful with high doses of vitamin D. Vitamin D is very important for health, but more isn't always better. Randomized controlled trials have shown that high doses of vitamin D are associated with an increased risk of falls and fractures, as well as an increased risk of kidney stones when taken alongside excessive calcium intake.
That said, maintaining proper vitamin D stores is essential for good health and healthy aging, especially for inflammation, autoimmune conditions, and cancer prevention, and studies suggest up to 40% of the US population is deficient in vitamin D. Unfortunately, the most recent guidelines from the Endocrine Society have been unhelpful in providing clear targets for vitamin D levels.
They even discourage routine testing in adults under 75 who have no risk factors for deficiency. Still, I think it's important to regularly check your vitamin D levels to make sure they're not too low or too high, especially if you're taking high doses, meaning more than 2,000 international units per day. Some people may require more aggressive dosing, particularly for autoimmune conditions, cancer prevention, or dementia prevention, which is a topic worth exploring further on its own.
Iron
Another supplement to avoid overconsuming is iron. I see this often in patients who take iron for fatigue or low energy. Iron can certainly help if fatigue is due to iron-deficiency anemia, but high iron levels can accumulate in organs and damage the heart, liver, and pancreas. High doses of iron can also deplete zinc levels, and zinc is essential for proper immune function, skin health, and the control of inflammation. Instead of iron supplements, I'd recommend getting iron from whole foods like red meat, shellfish, and legumes such as beans, lentils, and chickpeas.
Vitamin A
Next, check your daily multivitamin to make sure you're not getting too much vitamin A, since high doses have been linked to liver damage, poor bone health, and skin problems. Instead of supplementing vitamin A, I'd encourage getting it from natural foods like fatty fish (salmon or tuna), vegetables like sweet potatoes, or fruits like mangoes and watermelon.
Supplements Most People Are Missing
Psyllium Husk
Now, let's switch gears and talk about supplements most people should consider incorporating into their routine. First up is one of my favorite and most underrated supplements: psyllium husk. Psyllium husk has been shown to lower cholesterol, improve blood sugar control, and support optimal gut health.
A large meta-analysis, published in The Lancet in 2019, examined more than 200 studies and over 4,600 participants, finding that high-fiber intake, compared with low-fiber intake, was associated with a 15% to 30% decrease in all-cause and cardiovascular mortality. It also showed reductions in heart attacks, strokes, type 2 diabetes, and colorectal cancer.
Specific to psyllium husk, a recent systematic review and meta-analysis of 61 randomized controlled trials showed that psyllium improved insulin resistance, systolic blood pressure, blood sugar, and LDL cholesterol. Another benefit is that psyllium husk acts as a prebiotic, a fiber that feeds beneficial gut bacteria, promoting gut health with downstream benefits for heart health and inflammation.
Magnesium
The next commonly missing supplement worth discussing with your doctor is magnesium. It's estimated that 45% of the US population is deficient in magnesium, an important mineral for maintaining strong bones, heart health, metabolism, and sleep. Magnesium also has anti-aging properties and plays a role in cancer prevention.
Another important reason to maintain adequate magnesium is dementia prevention. Just like heart disease, dementia prevention starts in your 50s, or even your 40s, and magnesium plays a significant role. An observational study of over 6,000 people aged 40 to 73 found that higher dietary magnesium intake (about 550 mg per day) was associated with greater gray matter and hippocampal volumes compared with a lower average intake (about 350 mg per day), with the difference in brain health particularly evident in women. For an average 55-year-old in the study, this increase in brain volume translated to roughly one year of reduced brain aging.
Another study, following more than a thousand adults for 17 years, found that those consuming at least 196 mg of magnesium daily were 37% less likely to develop dementia across all ages studied.
It's also important to choose the right form of magnesium, as there are many options, like magnesium glycinate, taurate, oxide, or L-threonate, each suited to different needs.
Prioritize Sleep
Beyond supplements, one of the most important factors determining how gracefully you transition into older age is sleep. Sleep quality has a direct effect on the chronic diseases that plague us today, like heart disease, strokes, diabetes, and even cancer.
As we age, sleep quality typically declines, and people over 50 often don't get as much restorative sleep. Reduced sleep is strongly associated with memory impairment and increased risk of neurodegenerative diseases like Alzheimer's. Poor sleep also weakens the immune system, our first line of defense, not just against infections but against cancer as well, not to mention the metabolic disruptions that contribute to weight gain, diabetes, high blood pressure, and strokes. Because of all this, identifying and addressing the causes of poor sleep is essential.
The framework I typically give my patients to fix their sleep borrows from Matthew Walker's book Why We Sleep:
- Stick to a consistent sleep schedule, going to bed and waking up at the same time each day.
- Avoid caffeine at least 8 to 10 hours before bedtime. Many people drink caffeine too late in the day, and even if it doesn't prevent you from falling asleep, it can still disrupt sleep quality.
- Be careful with alcohol before bed. Many people use alcohol to relax at the end of the day, but it robs them of deep REM sleep, which is essential for brain restoration and memory consolidation.
- Take a hot bath or shower before bed. The drop in body temperature after getting out mimics the natural temperature drop that occurs as we fall asleep, helping trick your body into relaxing and falling asleep faster.
- Get timely sunlight exposure. Sunlight helps regulate your circadian rhythm. Aim for at least 10 to 15 minutes of sunlight within 30 minutes of waking up, which helps you feel more energized during the day and sets a natural timer to help you fall asleep roughly 15 hours later.
- Exercise for at least 30 minutes daily. Just avoid exercising too close to bedtime, ideally no later than 2 to 3 hours before you plan to sleep.
The Blood Test Most Doctors Don't Check: Lipoprotein(a)
Now let's talk about a very important blood test recommended for everyone at least once in their lifetime, but one that most doctors don't even know about: lipoprotein(a), or Lp(a). This is a fat and protein molecule that carries cholesterol in the blood, and it can triple the risk of heart attacks or strokes, sometimes at a very early age.
In fact, when we see heart attacks in young people who otherwise have no risk factors, like diabetes, smoking, or high blood pressure, chances are that person has elevated Lp(a). It's a genetic condition that runs in families and affects about one in five Americans, meaning there's a 20% chance you may have elevated Lp(a) levels. High levels accelerate plaque formation, promote blood clots, and can even cause early aortic stenosis, a narrowing of the heart valve connecting the main heart chamber to the rest of the body, which can eventually lead to heart failure.
This is why it's so important to check Lp(a) early to identify your risk and intervene before significant damage occurs. We currently don't have medications specifically approved to treat high Lp(a), but we can aggressively manage other risk factors to lower overall cardiovascular risk in the meantime. The good news is that several drugs currently in development have shown the ability to lower Lp(a) levels, with phase 3 trials for some expected to be completed as early as this year.
Conclusion
The choices made in your 50s, and even earlier, can meaningfully shape how well you age over the following decades. Avoiding excess vitamin D, iron, and vitamin A supplementation, incorporating evidence-based supplements like psyllium husk and magnesium, prioritizing high-quality sleep, and getting checked for lipoprotein(a), a critical but often-overlooked risk factor for early heart disease, are all concrete steps that can meaningfully reduce your risk of heart disease, stroke, dementia, and cancer. Many of these interventions are simple and low-cost, and the earlier they're implemented, the greater the potential benefit over the decades ahead.
FAQ
Is it possible to take too much vitamin D, iron, or vitamin A?
Yes. High doses of vitamin D have been linked to increased risk of falls, fractures, and kidney stones; excess iron can damage the heart, liver, and pancreas while depleting zinc; and high-dose vitamin A has been linked to liver damage and poor bone health. Getting these nutrients primarily through whole foods is generally safer than high-dose supplementation.
What supplements should most people over 50 consider?
Psyllium husk and magnesium are two commonly underconsumed nutrients with strong evidence supporting heart health, blood sugar control, gut health, and even dementia prevention.
How does sleep affect aging and disease risk?
Poor sleep quality is strongly linked to memory impairment, increased risk of neurodegenerative diseases like Alzheimer's, weakened immune function, and metabolic issues that contribute to weight gain, diabetes, high blood pressure, and heart disease.
What is lipoprotein(a), and why does it matter?
Lipoprotein(a), or Lp(a), is a genetically determined particle that carries cholesterol in the blood. Elevated levels, present in about 1 in 5 people, can triple the risk of heart attack or stroke and contribute to conditions like aortic stenosis, making it an important one-time test for cardiovascular risk assessment.
Is there a treatment for high lipoprotein(a)?
Not yet, specifically. There's currently no approved medication that directly targets Lp(a), though several drugs are in development. In the meantime, aggressively managing other cardiovascular risk factors is the recommended approach for those with elevated levels.